Mode of Study (Tick ): Regular [ ] Evening [ ] School Based [ ]

SCOTT CHRISTIAN UNIVERSITY P.O BOX 49-90100; Phone: +254 713 745 404/ +254 734 833 832 MACHAKOS, KENYA APPLICATION FOR ADMISSION IMPORTANT: Before filling out this Application Form, please read carefully the University Prospectus especially the statement on the design and objectives of Scott Christian University. Approved Christian character, a call to Christian ministry as verified by your church, ability to do serious first-degree level/diploma/certificate studies and a willingness to accept authority and guidance from the University are among the conditions of acceptance. Please tick [ ] the programme you are applying for [ ] Bachelor of Theology [ ] Diploma in Theology [ ] Diploma in Christian Ministry [ ] Certificate in Theology [ ] Certificate in Christian Ministry Mode of Study (Tick ): Regular [ ] Evening [ ] School Based [ ] USE HANDWRITING IN CAPITAL LETTERS PERSONAL INFORMATION: 1. Full Name: Title (check one): Mr./Mrs./Miss/Rev./Pastor Gender: [ ] Female [ ] Male 2. Present Address: Telephone: Email Address: 3. Permanent (or Home) Address: Home Telephone: Nearest Telephone where message can be left: 4. Other Important Address and/or Telephone 5. Place of Birth: Date of Birth: 6. Nationality: Kenyan ID No. / Passport No. (If from outside Kenya): Date of issue: Where issued: 7. Father s Full Name: 8. What is the attitude of your family toward your attending Scott Christian University? 1

9. Marital Status: [ ] Single [ ] Married [ ] Engaged [ ] Separated [ ] Divorced a. If engaged, please give the following information: Do you plan to marry before registration? [ ] Yes [ ] No Do you plan to marry while studying? [ ] Yes [ ] No Is your fiancée a born-again Christian? [ ] Yes [ ] No Is he/she pleased that you desire to study for Christian Ministry? [ ] Yes b. If married please give the following information: [ ] No Name of Spouse: _ Date of Marriage: Type of Marriage (check one): [ ] Civil (Government Office) [ ] Traditional/Customary [ ] Christian (Church Ceremony) If in church, give name of officiating minister: Minister s church affiliation or denomination: Was your spouse married before? [ ] Yes [ ] No If yes, explain: Is your spouse a born-again Christian? [ ] Yes [ ] No. If yes, since when? What church denomination is your spouse? Is your spouse in full agreement with your intention to study at Scott? [ ] Yes [ ] No if no, Please explain: c. Names of Children Date of Birth 10. Photograph: Send 2 photographs of yourself (facing camera), head and shoulders 2 by 1 1/2 (passport size) CHRISTIAN LIFE EXPERIENCE: 11. Have you accepted Christ as your personal Savior? [ ] Yes [ ] No If yes, when? 12. Spiritual Life History: On a separate sheet of paper write an essay of not less than 500 words presenting your spiritual life history which includes the following: a. Your conversion and growth in the Christian faith; b. Your sense of call to the Christian ministry; c. Your practical experience in various forms of Christian service in the church and in school; d. Your specific purpose for coming to study at Scott Theological College. 13. To what church (denomination) do you belong? 14. Where do you usually attend church services? 15. Have you been baptized in water since you accepted Jesus Christ as your personal Savior? [ ]Yes [ ]No 16. Alcoholic Beverages: On a separate sheet of paper write your understanding and attitude towards drinking alcohol, drugs and smoking. 2

EDUCATIONAL BACKGROUND: 17. Give the names of the schools you attended, together with the years at each school and certificates received: a. Primary School: Dates: KCPE/CPE Certificate No. Result: Date: b. Secondary School (Form IV): Dates: KCSE/KCE/EACE Certificate No. Result: Date: c. High School (Form VI): Dates: KACE/EACE Certificate No. Result: Date: 18. What other schools, colleges or courses have you attended? If you left before completion, why? 19. What achievements, awards or honors have you received in the areas of study, leadership, sports, music, or other? 20. Send photocopies of your Secondary School Certificates: Ordinary Level, Advanced Level, Kenya Certificate of Secondary Education (KCSE), and others. A certificate in a language other than English must be accompanied by a certified English translation. VOCATIONAL INFORMATION: 21. Are you presently employed? [ ]Yes [ ]No If yes, give the following information: a. Title or position: b. Employer s Name: _ c. Employer s Address: d. List your previous employers, starting with the most recent one: Position Name of employer Location Dates 3

FINANCIAL INFORMATION 22. Do you have in full the required fees for the first year? You will NOT be registered as a student unless you pay one term s in full as specified in the Fees Schedule. You also have to produce reliable documentary evidence of commitment and ability to pay the year s fees in full. 23. Who has promised to be your sponsor in supporting you through college? Name: Postal Address: MEDICAL INFORMATION: A Certificate of Health prepared by the University is to be completed by the applicant and a medical doctor. CONFIDENTIAL REFERENCES: Give the names and addresses of three referees, all of whom must be able to communicate well in English. Your application cannot be considered until references have been completed and sent directly to the Registrar, Scott Christian University, P. O. Box 49, Machakos, Kenya. Referees cannot be relatives. In addition to the recommendation by individuals, the College requires a report from your church council. If you are a member of the Africa Inland Church, a report from your District Church Council is required. If you are a member of another denomination, a report is required from an appropriate Church Council capable of endorsing your studies for Christian ministry. 1. Pastor of the Local Church: Address: 2. Church Elder or Missionary: Address: 3. School Teacher or Businessman: Address: 4. Name of AIC District Church Council or other Denominational Authority: Address: ADITIONAL INFORMATION How did you get to know about SCU? (Please Tick and explain) [ ] Advertisement in _ [ ] Recommendation from a friend [ ] Recommendation from a student (Please give their name) [ ] Exhibition (Please specify): Place: Date: [ ] Other (Please specify): I hereby certify that I accept the purpose and goals of Scott Christian University. I will support and uphold the Doctrinal and Christian Life standards of the University. I promise to obey the rules and regulations of the college if I should be accepted as a student. Signature: Date: 4

SCOTT CHRISTIAN UNIVERSITY P.O BOX 49-90100; Phone: +254 713 745 404/ +254 734 833 832 MACHAKOS, KENYA CERTIFICATE OF HEALTH FORM (FOR APPLICANT) NAME OF APPLICANT (IN CAPITAL LETTERS) PART I The following questions are to be answered by the applicant before taking the physical examination: 1. Have you ever been an in-patient in hospital or dispensary suffering from any disease or injury? if so, give details. 2. Apart from above, have you ever received medical treatment for any serious disease of injury?. If so, give details. 3. Is there any disease or illness that bothers you regularly such as: Hay fever? Diabetes? Stomach ulcers? Headache? Persistent cough? Frequent diarrhea? Skin eruption(sores)? Other (specify) 4. Is there any food or drink that you are unable to eat or drink or that causes you stomach trouble? if so, give details. 5. Have you had any recent notable weight loss? 6. Do you have any family members or close friends who have been diagnosed as having HIV/ AIDS? To the best of my knowledge, I have answered the above questions fully and truthfully. Date: Signature of Applicant PART II The following questions are to be answered by a Medical Doctor or duly authorized clinical officer. Does the above named Applicant report or show any symptoms of the following? If so, give details: 1. Any infectious of contagious disease? 2. Any chronic disorder or asthma, hay fever, diabetes, etc 3. Any ailment (stomach ulcers or allergies) that might prevent him/her from eating a normal diet? 4. Any ailment or disability that would make him/her unable to take part in sports or normal physical activities? 5. Any evidence of impaired vision? Hearing? I hear by certify that I have examined the above named person and that in my professional opinion he/she is Fit / unfit for the activities in the above school. Signature: Date: Full Name: Designation: Postal Address: Telephone/Mobile No: Official Rubber Stamp: 5

SCOTT CHRISTIAN UNIVERSITY P.O BOX 49-90100; Phone: +254 713 745 404/ +254 734 833 832 MACHAKOS, KENYA CONFIDENTIAL REFEREE FORM (1) Name of Applicant Name of Referee A WORD TO THE REFEREE: The above named person has applied for admission into the Certificate/Degree programme/diploma Programme (Tick one) at Scott Christian University. Since this person may one day become a leader in the church and community, your frank and honest evaluation is appreciated. Please answer the following questions, place in a sealed envelope and return immediately to the Registrar, Scott Christian University, P.O. Box 49, Machakos, Kenya. Your response will be read only by members of the University administration. 1. How long have you known this person? 2. How well do you know this person? Very well ; Casually ; Not well 3. As far as you know does this person use any of the following: Tobacco? ; Alcohol beverage? Habit-forming drugs? 4. State whether this person has ever been (a) expelled or suspended from School for any misconduct (b) convicted of a crime (c) in any questionable moral conduct If your answer is Yes to any of these, please give specific information. 5. Is this person honest? 6. State any special talent, skill or achievement in which the applicant excels 7. How well do you believe this person will be able to do serious diploma/degree level studies at Scott? Excellent ; above average ; fair ; poor ; don t know 6

8. Does the applicant complain about his/her circumstances? Yes, very much ; Yes, sometimes ; never ; don t know 9. Does the applicant cooperate well with people? Yes, very well ; Yes with some people ; Never ; don t know. 10. Briefly describe the applicant s reputation and standing in his/her school, church or community. 11. Is the applicant obedient to those in authority, and obedient to regulations and rules? Yes, very much ; yes, sometimes ; No ; Don t know 12. Every person has certain areas of strength and weakness. (a) What do you consider to be the applicant s strengths which would make him/her useful in his/her area of concentration? (b) What would you consider to be the applicant s weaknesses which would possibly be a hindrance in his/her area of concentration? 13. Please tick in the appropriate places the statements that seem best to describe the applicant: CHARACTERISTICS RATING COMMENT Social Acceptability Dependability Cooperation Well-liked by others Liked by others Tolerated Avoided by others Most dependable Usually dependable Somewhat dependable Not dependable Works very well with others Works fairly well with others Generally cooperative Cooperative under pressure Un-cooperative 7

Concern for Others Initiative Maturity Very outgoing and concerned about others Interested and often helpful Friendly but reserved Self-Centered Withdrawn, relates poorly with others Always takes the initiative Sometimes leads Average initiative Needs constant encouragement Exceptionally mature More mature than average Average maturity Immature but growing Very Immature To the best of my knowledge the information I have given above concerning the applicant in question is correct and accurate. Signature: Date: Full name: Address: 8

8. Does the applicant complain about his/her circumstances? Yes, very much ; Yes, sometimes ; never ; don t know 9. Does the applicant cooperate well with people? Yes, very well ; Yes with some people ; Never ; don t know. 10. Briefly describe the applicant s reputation and standing in his/her school, church or community. 11. Is the applicant obedient to those in authority, and obedient to regulations and rules? Yes, very much ; yes, sometimes ; No ; Don t know 12. Every person has certain areas of strength and weakness. (c) What do you consider to be the applicant s strengths which would make him/her useful in his/her area of concentration? (d) What would you consider to be the applicant s weaknesses which would possibly be a hindrance in his/her area of concentration? 13. Please tick in the appropriate places the statements that seem best to describe the applicant: CHARACTERISTICS RATING COMMENT Social Acceptability Dependability Cooperation Well-liked by others Liked by others Tolerated Avoided by others Most dependable Usually dependable Somewhat dependable Not dependable Works very well with others Works fairly well with others Generally cooperative Cooperative under pressure Un-cooperative 10

Concern for Others Initiative Very outgoing and concerned about others Interested and often helpful Friendly but reserved Self-Centered Withdrawn, relates poorly with others Always takes the initiative Sometimes leads Average initiative Needs constant encouragement Maturity Exceptionally mature More mature than average Average maturity Immature but growing Very Immature To the best of my knowledge the information I have given above concerning the applicant in question is correct and accurate. Signature: Date: Full name: Address: 11

8. Does the applicant complain about his/her circumstances? Yes, very much ; Yes, sometimes ; never ; don t know 9. Does the applicant cooperate well with people? Yes, very well ; Yes with some people ; Never ; don t know. 10. Briefly describe the applicant s reputation and standing in his/her school, church or community. 11. Is the applicant obedient to those in authority, and obedient to regulations and rules? Yes, very much ; yes, sometimes ; No ; Don t know 12. Every person has certain areas of strength and weakness. (e) What do you consider to be the applicant s strengths which would make him/her useful in his/her area of concentration? (f) What would you consider to be the applicant s weaknesses which would possibly be a hindrance in his/her area of concentration? 13. Please tick in the appropriate places the statements that seem best to describe the applicant: CHARACTERISTICS RATING COMMENT Social Acceptability Dependability Cooperation Concern for Others Well-liked by others Liked by others Tolerated Avoided by others Most dependable Usually dependable Somewhat dependable Not dependable Works very well with others Works fairly well with others Generally cooperative Cooperative under pressure Un-cooperative Very outgoing and concerned about others Interested and often helpful Friendly but reserved Self-Centered 13

Withdrawn, relates poorly with others Initiative Maturity Always takes the initiative Sometimes leads Average initiative Needs constant encouragement Exceptionally mature More mature than average Average maturity Immature but growing Very Immature To the best of my knowledge the information I have given above concerning the applicant in question is correct and accurate. Signature: Date: Full name: Address: 14

SCOTT CHRISTIAN UNIVERSITY P.O BOX 49-90100; Phone: +254 713 745 404/ +254 734 833 832 MACHAKOS, KENYA CONFIDENTIAL REFERENCE This form is intended for the Church or other relevant church leadership as may apply in the applicant s church background. Name of applicant: The above named person has applied for admission into the Certificate/Diploma/ Bachelor/ Masters Degree Programme (Tick one) at Scott Christian University. Since the applicant may in future become a leader in the church and/or community, the frank and the honesty evaluation by the local church leadership/pastor will be significant assistance to this office. Please indicate on this form whether you recommend the applicant, or not. Then sign and endorse with the office rubber stamp. Place the form in a sealed envelope and return directly to the Registrar, Scott Christian University, P.O. Box 49, 90100, MACHAKOS, KENYA. We appreciate your immediate action. The Church Leadership of has discussed the above named applicant s intention to join Scott Christian University for training in preparation for Christian ministry. We have decided before the Lord that (tick where appropriate): 1. 2. We do recommend this applicant. We do not recommend this applicant. If you do not recommend this person please give reasons or explain: Signature: Name: _ Position: Official Rubber Stamp: Telephone: The official rubber stamp of your church must appear on this document. 15